Sec. 7.5. (a) As used in this section, “covered individual” means a male individual who is:

(1) covered under a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or

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Terms Used In Indiana Code 5-10-8-7.5

  • Contract: A legal written agreement that becomes binding when signed.
(2) entitled to services under a contract with a health maintenance organization (as defined in IC 27-13-1-19) that is entered into or renewed under section 7(c) of this chapter.

     (b) As used in this section, “prostate specific antigen test” means a standard blood test performed to determine the level of prostate specific antigen in the blood.

     (c) A self-insurance program established under section 7(b) of this chapter to provide health care coverage must provide covered individuals with coverage for prostate specific antigen testing.

     (d) A contract with a health maintenance organization that is entered into or renewed under section 7(c) of this chapter must provide covered individuals with prostate specific antigen screening.

     (e) The coverage required under subsections (c) and (d) must include the following:

(1) At least one (1) prostate specific antigen test annually for a covered individual who is at least fifty (50) years of age.

(2) At least one (1) prostate specific antigen test annually for a covered individual who is less than fifty (50) years of age and who is at high risk for prostate cancer according to the most recent published guidelines of the American Cancer Society.

     (f) The coverage required under this section may not be subject to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable to covered individuals than the dollar limits, deductibles, copayments, or coinsurance provisions applying to physical illness generally under the self-insurance program or contract with a health maintenance organization.

     (g) The coverage for prostate specific antigen screening shall be provided in addition to benefits specifically provided for x-rays, laboratory testing, or wellness examinations.

As added by P.L.170-1999, SEC.2.